TY - JOUR
T1 - Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum- endemic regions: a meta-analysis
AU - Unger, Holger W.
AU - Hadiprodjo, Anastasia Jessica
AU - Gutman, Julie R.
AU - Briand, Valerie
AU - Fievet, Nadine
AU - Valea, Innocent
AU - Tinto, Halidou
AU - D’Alessandro, Umberto
AU - Landis, Sarah H.
AU - Ter Kuile, Feiko
AU - Ouma, Peter
AU - Oneko, Martina
AU - Mwapasa, Victor
AU - Slutsker, Laurence
AU - Terlouw, Anja
AU - Kariuki, Simon
AU - Ayisi, John
AU - Nahlen, Bernard
AU - Desai, Meghna
AU - Madanitsa, Mwayi
AU - Kalilani-Phiri, Linda
AU - Ashorn, Per
AU - Maleta, Kenneth
AU - Tshefu-Kitoto, Antoinette
AU - Mueller, Ivo
AU - Stanisic, Danielle
AU - Cates, Jordan
AU - Van Eijk, Anna
AU - Ome-Kaius, Maria
AU - Aitken, Elizabeth H.
AU - Rogerson, Stephen J.
PY - 2023/6/26
Y1 - 2023/6/26
N2 - In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.
AB - In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.
U2 - 10.1038/s41598-023-37431-3
DO - 10.1038/s41598-023-37431-3
M3 - Article
SN - 2045-2322
VL - 13
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 10310
ER -
